Effectiveness of Imiquimod 5% Cream for Treatment of Extensive Anogenital Warts in a Seven-Year-Old Child

Abstract

Conventional treatment options for anogenital warts in prepubertal children rely on chemical and physical destruction methods that can be difficult and painful and frequently require the use of general anesthesia. Other approaches include the use of immunotherapies, as topical imiquimod and intralesional or systemic interferon. We report a 7-year-old girl with extensive anogenital warts who was successfully treated with topical 5% imiquimod cream.

Successful treatment with topical imiquimod of anal Buschke-Löwenstein tumor in a child

“…Systemic chemotherapy with methotrexate, bleomycin may be tried in extensive or recurrent BLT in adults. The use of imiquimod for pediatric anogenital condyloma was reported since 2001 with good results . Including our case, there were 10 girls and 10 boys and 90% of the patients achieved remission without recurrence.…”

“…Including our case, there were 10 girls and 10 boys and 90% of the patients achieved remission without recurrence. In these reports, the duration of the treatment was from 3 weeks to 4 months . Hence, imiquimod 5% cream represents a novel treatment of BLT and is approved by the United States Food and drugs administration .…”

Effectiveness of imiquimod 5% cream for treatment of perianal warts in a 28‐month‐old child

“…Previous physical methods relied on chemically destructive measures, such as topical application of podophyllin, 5‐fluorouracil, bi/trichloroacetic acid, and podophyllotoxin, and physical destruction methods included cryotherapy, laser vaporization, electrocautery, and surgical excision in adults just as in children. These physical methods, which are often painful, may result in scarring and frequently require the use of general anesthetics; recurrences are common 4,5 …”

“…Recently, the use of imiquimod for pediatric anogenital warts has been reported, 2,4,6–8 and it generally obtained good results. There were five reports 2,4,6–8 of treatment with imiquimod for pediatric condyloma (Table 1). Including the present case, of the six boys and seven girls, 11 (84.6%) achieved remission without recurrence.…”

“…These physical methods, which are often painful, may result in scarring and frequently require the use of general anesthetics; recurrences are common. 4,5 Imiquimod is a topically active immunomodulatory agent that induces keratinocytes to produce interferon-alpha and other cytokines to inhibit viral replication. Imiquimod also enhances cell-mediated immunity by the activation of Langerhans cells, enhancing antigen presentation to T cells; it has been proven effective for the treatment of anogenital warts in adults, producing a lower recurrence rate than other standard therapies, 4-8 as well as for long-lasting cutaneous warts in children.…”